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Introduction: Transcatheter closure of perimembranous ventricular septal defects (pmVSD) using various devices has become a successful procedure in recent years. This study aims to compare the outcomes of patients with congenital pmVSD weighing less than 10 kg who underwent closure using Amplatzer Duct Occluder (ADO) II and Konar-MFTMVSD occluder (MFO) devices. Methods: This retrospective study included 52 patients with hemodynamically significant pmVSD, suitable for transcatheter closure, between January 2018 and January 2023. The patients were divided into two groups: ADO II device group (n=22) and MFO group (n=30). Both groups were evaluated in terms of procedural duration, success rate, complications, and to medium-term followup data. Results: The average age of the patients was 11.6 months (4.1-27). The average weight was 7.35 kg (3.6-9.9). The mean defect size for the left ventricle (LV) side was 7.0 mm (5.4-11.2) for MFO and 4.7 mm (3.6-6.4) for ADO II. For the right ventricle (RV) side, it was 5.7 mm (4.9-9.2) for MFO and 3.9 mm (3.4-.5.2) for ADO II. During the closure procedure, antegrade technique was used in 19 (63.3%) patients with MFO, and retrograde technique was used in 15 (68.1%) patients with ADO II. The success rates of VSD closure were similar in both groups (95.4% for ADO II and 96.6% for MFO). The procedure and fluoroscopy times were shorter with the MFO device (p<0.05). Similar rates of hemodynamic complications were observed in both groups. There was no significant difference between the two groups in terms of major complication rates. One patient who received the ADO II device developed complete atrioventricular block (CAVB) six months later and required pacemaker implantation. In one patient who received the MFO device, CAVB occurred three days later, and the device was removed. In one patient with MFO device placement, left bundle branch block (LBBB) developed within 24 hours and resolved after steroid treatment. No significant aortic regurgitation or tricuspid valve damage was observed in the entire series. There were no incidences of death, hemolysis, or infective endocarditis. The mean follow-up period in our study was 41.2 months (12-61). Conclusion: High success rate and low complication rate are crucial in terms of selecting the right device and managing potential situations during and after the procedure. Both devices have provided significant advantages over other devices in transcatheter closure due to their flexibility, ease of application, and small delivery system. The lack of a suitable device for ADO II in large (>6 mm) defects and the selection of the MFO device in cases with SAR < 3 mm have made MFO more preferred over ADO II. Both MFO and ADO II are effective and safe devices with excellent success and closure rates in appropriately selected pmVSDs, along with low morbidity incidence. Our series is the first study comparing the mid-term outcomes of MFO and ADO II devices in patients weighing less than 10 kg in the literature. [ABSTRACT FROM AUTHOR]

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